A rapid increase in macrolide resistance in Streptococcus pyogenes isolated in Poland during 1996-2002.

Author(s):Szczypa K, Sadowy E, Izdebski R, Hryniewicz W

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Abstract OBJECTIVES: The aim of this study was to investigate Polish clinical isolates of Streptococcus pyogenes collected during a 7 year period using phenotypic and genotypic techniques. METHODS: A total of 816 isolates of S. pyogenes recovered from 33 medical centres in Poland were tested for their susceptibility to various antimicrobial agents. Erythromycin-resistant isolates were analysed by PFGE, multilocus sequence typing and emm typing methods. RESULTS: The tetracycline resistance rate was high (43\%) among all S. pyogenes strains. Ninety-eight (12\%) isolates were resistant to erythromycin. A low prevalence of the M phenotype (5.1\%) associated with the presence of the mef(A) gene was found. All the isolates of the iMLSB phenotype harboured the erm(TR) gene. Out of the cMLSB isolates, 71.4\% and 28.6\% carried erm(TR) and erm(B), respectively. All isolates with erm(B) were resistant to telithromycin. PFGE analysis discerned 13 different patterns, A-N, with two predominant PFGE profiles--A (41 isolates) and B (25 isolates)--that in multilocus sequence typing corresponded, respectively, to a novel sequence type (ST) 367 and ST63. Overall, the representatives of these clones accounted for >90\% of isolates of the iMLSB phenotype. CONCLUSIONS: A significant increase in erythromycin resistance was observed among clinical S. pyogenes collected in Poland over a 7 year period driven by the spread of two epidemic clones.

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